“No Matter What Happens, Soldiers Will Get Proper Care”

On the opening day of the conference, Hungarian and American specialized hospital care, military health care education, multinational cooperation, and various illnesses were in the focus. In their address Colonel Dr. Zsuzsanna Szilágyi, Acting Commander and Preventive Director of the Hungarian Defence Forces’ ’Dr. Radó György’ Military Medical Centre, and General Keith Gallagher, Commander of the Europe Regional Medical Command emphasized that strong relations have evolved between Hungary and the United States."We fight together, we cure together, " said Dr. Zsuzsa Szilágyi, in the opinion of whom there is always a need for development and exchange of views.

Dr. Radó György Military Medical Centre

At the conference the Dr. Radó György Miliary Medical Centre and its Aviation Medicine, Health Examination and Research Institute was introduced by Dr. Sándor Szabó, the deputy director of the institute. Dr. Szabó told the attendees that Hungarian medical care has gone through many changes in the past three years. In 2007, the Ministry of Defence appointed a new management to lead the institute, for instance Brigadier-General Dr. András Németh, Commander, Colonel (eng.) György Bódi, Commander, Deputy Financial Director, and Colonel (eng.) Gábor Csókos, Chief of Staff. “Our primary mission is prevention, evacuation, medical logistics, education, training, and research. It is important that we have daily contact with other ministries and bureaus," Dr. Sándor Szabó underlined. The responsibilities of the Fitness Evaluation Institute include the examination and evaluation of the physical and mental fitness of professional and contracted service personnel for active duty and abroad service. The Public Health Care Institute acts as a public health care and epidemiological authority for the personnel and it is also responsible for the complex hygienic supervision of the Hungarian Defence Forces. The Health Care Institute implements projects focusing on a healthy way of life, health education, drug prevention, moreover it offers advanced courses for professionals, and their duties also include the psychological preparation of the personnel for missions.

As Dr. Szabó explained in detail, chemical-biological-radiological and nuclear weapons-related and medical defence-related medical-biological research and development are carried out in the Scientific Institute. He also spoke about the tasks of the Aviation Medicine, Health Examination and Research Institute. Like he said, we can talk about four kinds of danger in the air: it can be the environment, the human mind, the human body, or the aircraft itself. Many pilot candidates, parachuters and divers are tested in the Institute by the flight surgeons.

Diplomacy of medical officers

David Schall, MD, of the US European Command told the medical officers of the missions to be careful: "Be careful with donations, do not want to ’save’, and the most important thing: do not destroy the local doctors’ means of subsistence!" He also emphasized that it is very important to keep contact with various aid organizations, such as the USAID (United States Agency for International Development), NGOs, and the other nations. The doctor also called attention to the primary cause of death in children, diarrhoeic diseases.

About the plans for the future Dr. Schall said that a well-operating infrastructure has to be developed – hospitals, educational institutions, and institutions supporting the education of the leaders have to be established and communication needs further development.

He mentioned the Afghanistan PRT as a good example: like he said, there is good food supply, the water is clean, there are courses for local midwives, the dentistry program is good, and patients are taken good care of. Finally David Schall spoke highly of the work done at the Moldova Burn Center that was established in 2008.

Lieutenant-Colonel Dr. Sándor Pellek gave a lecture on multinational cooperation from the Hungarian side. Like the lieutenant-colonel said, in a multinational environment it is important to win the trust of both the locals and our partners, the other nations. "There can be many difficulties: the language barrier, the lack of team work, different levels of expertise, different legal aspects or documentation, etc. may cause problems," said Dr. Pellek.

He explained: in the future a common educational standard will have to be set and it is also necessary to elaborate a multinational training and a program. "The soldiers must be aware that they will get proper care, no matter what happens to them," added the lieutenant-colonel.

Major Kelly Morales also emphasized the strengthening of multinational relations and gave a lecture on the American ‘Military To Military Training’. The first step of the military cooperation was Romania in 2008, where Romanian and American medical officers exchanged their experiences and conducted a joint exercise, similarly to the Bulgarian and American doctors in Bulgaria in the same year. The major said that there was another training this summer in both Romania and Bulgaria, where the participants attended the course together and learned about evacuation techniques, special transport equipments, health and medical care, and they also had an opportunity to practice together.

Major Morales explained: there are plans for organizing more than one training a year in the future, with new locations and participants, and as a result of that, international relations will grow stronger.

Epidemics, murder, suicide

At the conference the current epidemics and illnesses were also discussed, for instance one of the main causes of death in children, the diarrhoeic diseases. The topic of the H1N1 also came up: Lieutenant-Colonel Dr. Katalin Meglécz, Chief Epidemiologist of the Hungarian Defence Forces called attention to the dangers of the pandemic (a disease widespread over several countries) and told about the antecedents. She said that in 1889 there was a virus called H3N8 in Russia, then in 1900 the H1N1 broke out in Hong Kong, in 1957 H2N2 appeared in Asia, and in 1968 H3N2 broke out in Hong Kong again.

“In America the H1N1 was detected on 25 April for the first time, in Europe it happened five days later. Hungary will get the vaccines in October," ensured the audience the lieutenant-colonel who also told us that most of the victims were between the age of 25 and 64 and had some kind of chronic, in some cases a latent disease. Dr. Meglécz underlined: they are preparing the military medical staff and the system for receiving the vaccines and for laboratory diagnosis. All the 26,000 Hungarian soldiers will be vaccinated.

Deputy Commander Eric Shuping, MD, delivered a lecture on an epidemic that broke out in Georgia in 2008, and Daniel Bruzzini, MD called attention to the childhood disease called DIVA and its therapies.

Steven Brewster, MD, talked about behavioural and social health and within that, suicides in the first place. Furthermore he drew attention to the Fort Carson-case, when between 2005 and 2008 soldiers stationed at Fort Carson killed several Iraqi civilians.

The doctor explained their research in detail and said that they examined the background of these cases for a long time and studied the families the suicidal and killer soldiers have come from, if they had drug or alcohol problems, and their stress factors. The number of suicides has increased in the American military (there has been a leap since the Iraqi mission began) and the estimate until 2011 shows a further growth.

Institutes at the service of medical officers

Hamilton Lee, MD, of the Landstuhl Regional Medical Centre (LRMC) spoke about medical care in theatres of operations and the changes in evacuation. “While in 1975 evacuation took almost 45 days in Vietnam, today in OIF (Operation Iraqi Freedom) and OEF (Operation Enduring Freedom) transport and providing medical care takes 4 days. The process of evacuation and curing takes place on four levels: the first level being evacuation itself, with the help of special vehicles. The second level is local medical care, provided by the FST (Forward Surgical Team) or the FRSS (Forward Resuscitative Surgery) teams. The third level is medical care in a field hospital, and the fourth level is curing in the Landstuhl hospital," said Dr. Lee. The Landstuhl hospital has 162 beds in total but in case of emergency it can be extended to 310 with spare beds.

Colonel Dr. István Kopcsó, Director of the Ministry of Defence Military Health Care Centre of Excellence (HM KEKK) gave an account of the Hungarian centre at the conference. The institute operates in cooperation with the military organizations of the Hungarian Defence Forces, the organs and organizations of the MoD, other ministries, and NATO and non-NATO foreign organizations. The colonel emphasized: in line with the core functions of the HM KEKK they put an emphasis on education, training, doctrine and standard development. The responsibilities of the centre include the maintenance of the health and physical condition of the professional and contracted personnel for the NATO, and the elaboration of health development and health education concepts.